演題抄録

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開催概要
開催回
第56回・2018年・横浜
 

分子標的薬を併用したFOLFOXIRI療法により切除可能となった進行大腸癌症例の検討

演題番号 : P19-3

[筆頭演者]
演者)福永 睦:1 
[共同演者]
小西 健:1、松野 裕旨:1、松尾 容子:1、武岡 奉均:1、岡田 一幸:1、太田 英夫:1、横山 茂和:1、小西 宗治:1、小林 研二:1

1:兵庫県立西宮病院・外科

 

BACKGROUND: FOLFOXIRI therapy was superior to FOLFIRI therapy in Phase 3 trial in unresectable colorectal cancer. In combination with bevacizumab(Bmab), it was equally effective in the Phase 3 trial. In Japan, this therapy is recommended since the 2014 version of the colorectal cancer treatment guidelines.
PURPOSE: We studied advanced colorectal cancer cases treated with FOLFOXIRI combined with molecular targeted drugs (MTD) in expecting high response rate leading to be resectable.
DOSAGE: The drug amount was set as follows; Irinotecan:150mg/m², Oxaliplatin:85mg/m², 5FU:2400mg/m², and adding MTD was allowed.
RESULTS: In 6 cases aimed at conversion surgery, 4 cases could be excised, including 2 primary tumors and 2 liver metastatic lesions. Cecal cancer and rectal cancer, both of which were RAS mutant type and judged that radical resection was impossible at the initial surgery, were performed bypass surgery and colostomy. Cecal cancer case was treated 13 courses of FOLFOXIRI combined with Bmab, then right hemicolectomy and resection of right iliac muscles and femoral nerve were performed. Rectal cancer case was treated by 5 courses of FOLFOXIRI combined with Bmab, then rectal resection and small intestine and bladder partial excision were performed. Hepatic metastasis resected cases were H2 grade case (RAS wild type) and H3 grade case (RAS wild type). In the former, sigmoidectomy followed by 7 courses of FOLFOXIRI combined with cetuximab was performed, further followed by liver right lobectomy as conversion surgery. In the latter, sigmoidectomy was performed with positive paraaortic lymphnode metastases. Despite RAS wild type, FOLFOXIRI in combination with Bmab was enforced in 12 courses, after confirming that metastases were identified only in liver by PET/CT, and partial resection of liver as conversion surgery was done.
SUMMARY: In spite of a few cases, FOLFOXIRI therapy in combination with MTD could be a useful therapeutic tool for unresectable colorectal cancer.

キーワード

臓器別:大腸・小腸

手法別:化学療法

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